The Press Room of the Mississippi Hospital Association includes, in addition to MHA-specific press information, statistics and studies useful to health care reporters.

November 07, 2014

How Medicare calculates reimbursement rates for hospitals and other health facilities or services provided to Medicare patients can be complex. The Medicare Payment Advisory Commission has updated its Payment Basics series.

The series provides a short overview for the different Medicare payments systems that will help in better understanding them. Here is a list of what's available in the series.

August 05, 2014

Recently, the Medicare Payment Advisory Commission (MedPAC) released a data book analyzing various aspects of Medicare expenditures, including a chapter on the dually eligible Medicare-Medicaid population. The report notes that duals continue to be one of the sickest costliest populations in both programs, with total spending on the population being roughly double that of other beneficiaries.

January 17, 2014

Underpayment by Medicare and Medicaid to U.S. hospitals reached $56 billion in 2012, according to a factsheet released Jan. 14 by the American Hospital Association. Based on data from the AHA’s Annual Survey of Hospitals, Medicare reimbursed just 86 cents and Medicaid 89 cents for every dollar hospitals spent caring for these patients in 2012.

As reported earlier this month, U.S. hospitals also provided $45.9 billion in uncompensated care (charity care and bad debt) in 2012, $4.8 billion more than in 2011.

December 20, 2013

One out of every five dollars Medicare spends goes to nursing homes, home health services or other post-acute facilities and services.

This chart breaks down Medicare’s 2011 spending into five broad categories. The totals may not add up exactly to 100 percent because of rounding.

Spending has been adjusted for the different wage scales Medicare pays as well as special payments such as for hospitals that teach residents. The spending per Medicare beneficiary has been adjusted to take into account different illness levels among states’ Medicare beneficiaries.

The figures include only traditional “fee for service” Medicare spending on beneficiaries age 65 and older. Spending on Medicare managed care plans, also known as Medicare Advantage, is not included.

May 03, 2013

Sicker, more complex Medicare patients are driving up the intensity of emergency department care, according to an American Hospital Association report released May 2. The report, which is based on an analysis of Medicare claims data conducted by The Moran Company, found that the number of ED services provided to Medicare beneficiaries is growing and patients’ needs are shifting toward services that demand the use of more resources.

“The reality is that seniors who come to the hospital ED are sicker and have more chronic illnesses,” said AHA President and CEO Rich Umbdenstock. “Hospitals are striving to meet their communities’ needs, which means caring for patients who need more – and more intensive – services than ever before.”

While some policymakers have raised concerns that the shift toward ED services that require more resources is leading to higher Medicare spending, the report shows that the overall use of ED services is also increasing, and EDs are serving more Medicare patients with behavioral health diagnoses and more patients enrolled in both Medicare and Medicaid.

December 12, 2012

The Medicare population is becoming older and sicker, contributing to an increase in patient acuity and use of health care services, according to an American Hospital Association TrendWatch report released on Dec. 11. The report examines the dramatic rise in chronic disease, obesity and complex conditions such as end-stage renal disease in recent years; how patients are living longer due to advances in medicine and improved use of health care services; and the higher intensity care required of this older and sicker Medicare population.

“Chronic disease is rising among Medicare patients,” the report concludes. “That’s why it’s not surprising that the new patient classification system (MS-DRGs) – designed to account for complications and comorbidities and their associated resource use – shows a rise in patient case mix over time relative to the old system. Policy makers should carefully consider the trends of increasing acuity in the Medicare patient population as they seek changes to payment policy.”

October 01, 2012

While pollsters are busy this week predicting the outcome of our next presidential election, a pair of surveys looked at how health care might fare – and a few surprises emerged. Regardless of who wins the White House, one survey found, Americans believe Obamacare will survive, albeit not entirely intact. But according to another poll, it’s the younger generation of voters that don’t necessarily favor that result.

About 14.3 million people in original Medicare received an annual wellness visit or other preventive service at no cost to them in the first five months of 2012, the Centers for Medicare & Medicaid Services announced June 11. That includes 1.1 million people who received an annual wellness visit. Medicare last year began offering annual wellness visits, cancer screenings and other recommended preventive services with no co-payment or deductible, as required by the Patient Protection and Affordable Care Act. In 2011, 32.5 million enrollees took advantage of the benefit.

“These variations reflect a state’s demographic profile as well as state policy choices in Medicaid eligibility and coverage,” the report notes. “In general, states in the East – which tend to have older overall populations – have a higher share of Medicaid enrollees who are dual eligibles than those in the Midwest and West. However, states with a relatively low share of Medicaid enrollees who are duals (such as California and Illinois) may have a much higher number of dual eligibles enrolled in Medicaid than states with a higher share, since these states have larger overall populations.”

Mississippi is one of the 19 states with the highest percentage of dual eligibles (18% and over). According to the report, 26 states are developing proposals for a federal demonstration to integrate Medicare and Medicaid services and financing for dual eligibles.

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The Mississippi Hospital Association's Press Room offers MHA and Mississippi news in addition to health care news we think may be of interest to health care reporters. If you wish to receive email updates, subscribe below. If you need further assistance, contact Shawn Rossi at (800) 289-8884, (601) 368-3237 or srossi@mhanet.org.